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Citation
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Azoulay E, Cariou A, Bruneel F, Demoule A, Kouatchet A, Reuter D, Souppart V, Combes A, Klouche K, Argaud L, Barbier F, Jourdain M, Reignier J, Papazian L, Guidet B, Géri G, Resche-Rigon M, Guisset O, Labbé V, Megarbane B, Van Der Meersch G, Guitton C, Friedman D, Pochard F, Darmon M, Kentish-Barnes N, FAMIREA study group. Am. J. Respir. Crit. Care Med. 2020; ePub(ePub): ePub. |
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Abstract
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RATIONALE: Frontline healthcare providers (HCPs) during the COVID-19 pandemic are at high risk of mental morbidity.
OBJECTIVE: To assess the prevalence of symptoms of anxiety, depression, and peritraumatic dissociation in HCPs.
METHODS: Cross-sectional study in 21 ICUs in France between April 20 and May 21, 2020. The Hospital Anxiety and Depression Scale and the Peritraumatic Dissociative Experience Questionnaire were used. Factors independently associated with reported symptoms of mental health disorders were identified.
MEASUREMENTS AND MAIN RESULTS: Response rate was 67%, with 1058 respondents (median age 33 y, 71% women, 68% nursing staff). The prevalence of symptoms of anxiety, depression, and peritraumatic dissociation was 50.4%, 30.4%, and 32%, respectively, with the highest rates in nurses. By multivariable analysis, male sex was independently associated with lower prevalence of symptoms of anxiety, depression, and peritraumatic dissociation (Odds Ratio of 0.58(0.42-0.79), 0.57(0.39-0.82) and 0.49(0.34-0.72), respectively. HCPs working in non-university-affiliated hospitals and nursing assistants were at high risk of symptoms of anxiety and peritraumatic dissociation. Importantly, we identified six modifiable determinants of symptoms of mental health disorders: fear of being infected, inability to rest, inability to care for family, struggling with difficult emotions, regret about the restrictions in visitation policies, and witnessing hasty end-of-life decisions.
CONCLUSIONS: HCPs experience high levels of psychological burden during the COVID-19 epidemic. Hospitals, ICU directors, and ICU staff must devise strategies to overcome the modifiable determinants of adverse mental illness symptoms. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Language: en |